POS0878 SCREENING FOR THE EARLY IDENTIFICATION OF PSORIATIC ARTHRITIS WITH AXIAL INVOLVEMENT (AXPSA) IN A COHORT OF ITALIAN PATIENTS AFFECTED BY PSORIASIS: RESULTS OF A DERMO-RHEUMATOLOGIC CROSS-SECTIONAL STUDY (ATTRACT)
Authors: V. Paci, M. M. Luchetti, I. Cimaroli, A. Agostinelli, C. Macchini, R. Sordillo, M. Gigli, L. Massaccesi, F. Fiorini, V. Marconi, L. Perini, M. Ciferri, M. Carotti, A. Giovagnoni, G. Polonara, F. Sessa, A. Campanati, M. Giannoni, F. Diotallevi, A. Marani, A. Offidani, D. Benfaremo, F. Proft, D. Poddubnyy, G. Moroncini
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease characterized by different domains.<sup>[1]</sup> Interest is growing towards early diagnosis of axial PsA (AxPsA), to allow better disease characterization and well-timed targeted therapeutic strategies. <h3>Objectives</h3> In this study, we report preliminary results of a rheumatological screening strategy settled in a dermatological centre. Primary objective is to validate the screening tool in a cohort of Italian patients affected by psoriasis, improving early diagnosis of AxPsA. Secondary objectives are: 1. classification and characterization of axial involvement; 2. profiling of patients' characteristics and comorbidities. <h3>Methods</h3> Patients were enrolled in the ATTRACT study (<b>A</b>xial psoria<b>T</b>ic ar<b>T</b>hritis sc<b>R</b>eening <b>A</b>n<b>C</b>ona i<b>T</b>aly) according to the following inclusion criteria: <b>1.</b> age &gt; 18 years; <b>2.</b> diagnosis of psoriasis (Pso) by a dermatologist; <b>3.</b> capacity to understand and sign the informed consent. Patients who assumed any DMARD 12 weeks prior to screening were excluded. Study design is shown in Figure 1. The Dermatologic-Centred Screening (DCS) tool<sup>[2]</sup>, recently validated for early identification of AxPsA, was translated in Italian and administered to outpatients in the dermatological clinic. Patients were divided in the following groups based on answers to the Inflammatory Back Pain (IBP) related questions of the DCS: <b>A.</b> no affirmative answers (low AxPsA probability); <b>B.</b> all affirmative answers (high probability); <b>C.</b> only two affirmative answers (intermediate probability). Group B &amp; C patients underwent complete rheumatological examination comprehensive of clinimetric, laboratoristic and genetic data; Xray and MRI imaging of the whole spine and pelvis were performed in all of them classifying in: <b>a.</b> confirmed AxPsA; <b>b.</b> peripheral PsA involvement only; <b>c.</b> PsA excluded. <h3>Results</h3> N.366 patients were screened; n.101 met exclusion criteria. N.91 (34.3%) were classified as group A, n.125 (47.2%) as group B, n.49 (18.5%) as group C. Following characteristics were notable: a. female sex more represented in group B; b. mean age higher in group C; c. onichopathy more represented in group A &amp; C. List of patients' clinical characteristics is shown in Table 1 Among group B patients, n.28 (22.4% - B1) were classified as PsA excluded; n.22 (17.6% - B2) as isolated per-PsA (according to CASPAR criteria), n.39 (31.2% - B3) as AxPsA (n.34 fulfilling ASAS criteria, n.31 with concomitant per-PsA). Among group C, n.15 (30.6% - C1) as PsA excluded; n.3 (6.1% - C2) as isolated per-PsA, n.5 (10.2% - C3) as AxPsA (n.4 fulfilling ASAS, n.5 with concomitant per-PsA). N.13 patients are still awaiting results of imaging; n.49 (n.24 group B, n.25 group C) refused to undergo imaging and were considered lost at follow-up. <h3>Conclusion</h3> The DCS tool may be useful for PsA screening in a real-life cohort of Pso patients, an Inflammatory Back Pain was reported by about half of the screened Pso patients. This tool helped to identify a substantial number of naïve patients not only affected by AxPsA but also by peripheral PsA in a purely dermatological setting. <h3>References</h3> [1]Coates LC et al. <i>Nat Rev Rheumatol 2022</i> [2]Proft F, et al. <i>Ann Rheum Dis 2022</i> <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.